LEGACY ANESTHESIA SERVICES, PLLC (NPI# 1902931199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902931199 |
| Entity Type | Organization |
| Organization Name | LEGACY ANESTHESIA SERVICES, PLLC |
| Practice Address |
1575 20th St Nw Suite 203 Faribault MN 55021 |
| Practice Telephone | 6127351469 |
| Mailing Telephone | 6127351469 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DEAN STEVEN ANDERSON (CHIEF MANAGER) |
| Authorized Official Telephone | 6127351469 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MN | Ambulatory Health Care Facilities |
| Street Address |
1575 20TH ST NW SUITE 203 |
| City | FARIBAULT |
| State | MN |
| Zip Code | 55021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023541695 | Carley Banks | Advanced Practice Dental Therapist | 1575 20th St Nw, Faribault, MN 55021 | 2017-04-10 |
| 1033642947 | Lauren Johnson | Advanced Practice Dental Therapist | 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 | 2017-04-07 |
| 1215479530 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 1575 20th St Nw, Faribault, MN 55021-2930 | 2016-11-17 |
| 1073900718 | Angella Schaefer | Optometrist | 1575 20th St Nw, Suite 101, Faribault, MN 55021-2930 | 2015-04-21 |
| 1104256106 | Michelle Storlie | Dental Therapist | 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 | 2013-11-13 |
| 1962840520 | Kathleen Baker Gerber | Dentist | 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 | 2013-06-05 |
| 1386924231 | Sound Sleep Centers | Clinic/Center | 1575 20th St Nw, Suite 209, Faribault, MN 55021-2930 | 2011-08-24 |
| 1174834022 | Misty Purfeerst | Optometrist | 1575 20th St Nw, Ste 101, Faribault, MN 55021-2930 | 2010-06-25 |
| 1306018544 | King Orthodontics Ltd | Clinic/Center | 1575 20th St Nw, Suite 202, Faribault, MN 55021-2930 | 2008-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872831 | Kent William Lundstrom | Pharmacist | 612 4th Street Nw, Faribault, MN 55021 | 2020-08-19 |
| 1053957357 | M&t Sisters of Serendipity Pllc | Counselor | 212a Centralave, Faribault, MN 55021 | 2019-11-21 |
| 1639720485 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 200 8th Avenue Nw, Faribault, MN 55021 | 2019-09-24 |
| 1235663428 | Tanya Borchert | Social Worker | 100 State Avenue, Faribault, MN 55021 | 2017-04-14 |
| 1235589854 | Bashir Omar I | Interpreter | 2426 Park Ave # 309, Faribault, MN 55021 | 2016-06-14 |
| 1790150381 | Rainbow United Care Transportation LLC | Non-emergency Medical Transport (VAN) | 1738 Patrick Bay, Faribault, MN 55021 | 2015-12-08 |
| 1740625938 | Steven James Klapmeier | Family Medicine | 1101 Linden Lane, Mcfffrb Health Service, Faribault, MN 55021 | 2013-05-02 |
| 1528306040 | Discovery Public School of Faribault | Local Education Agency (LEA) | 126 8th St. Nw, Faribault, MN 55021 | 2013-01-17 |
| 1164790374 | Emmanuel Douah | Pharmacist | 612 4th Avenue Nw, Faribault, MN 55021 | 2011-12-02 |
| 1770873937 | Faribault Senior Living LLC | Assisted Living Facility | 843 Faribault Road, Faribault, MN 55021 | 2011-04-08 |
| Find all providers in zip 55021 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114057023 | Crossroads Surgery Center Inc | Clinic/Center | 1575 20th St Nw Ste 203, Faribault, MN 55021-2930 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079992 | Woodbury Surgery Center, LLC | Clinic/Center | 587 Bielenberg Dr Ste 100, Woodbury, MN 55125-4452 | 2020-10-09 |
| 1902410368 | Inspired Spine Surgcenter LLC | Clinic/Center | 7400 France Ave S Ste 102, Edina, MN 55435-4738 | 2020-09-03 |
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1215573209 | Hiawatha Surgery Center LLC | Clinic/Center | 2020 E 28th St Ste 100, Minneapolis, MN 55407-1453 | 2019-11-25 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1942760285 | Altru Health System Ambulatory Surgery Centers LLC | Clinic/Center | 400 S Minnesota St Ste B, Crookston, MN 56716-1808 | 2019-03-22 |
| 1396229746 | Avera Marshall | Clinic/Center | 1521 Carlson St Ste 200, Marshall, MN 56258-2626 | 2018-09-21 |
| 1891297925 | Pediatric Center Holdings, LLC | Clinic/Center | 15450 Highway 7 Ste 200, Minnetonka, MN 55345-3522 | 2018-03-05 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LEGACY ANESTHESIA SERVICES, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.